SCIENTIST AT WORK: AARON T. BECK

By ERICA GOODE

Published: January 11, 2000

PHILADELPHIA—
The session, Dr. Aaron T. Beck recalls, began like many others. The woman lay on the couch, describing her sexual encounters with men, while Dr. Beck, at the time a recent graduate of the Philadelphia Psychoanalytic Institute, sat behind her, scribbling in his notebook.

Arms crossed on his chest, red bow tie resplendent, pale blue eyes keen beneath a shock of white hair, the founder of the fastest growing, most extensively studied form of psychotherapy in America is telling this story to explain how he eventually came to leave Freud behind.

Sitting in his office at the Beck Institute for Cognitive Therapy and Research in Bala Cynwyd, outside Philadelphia, he offers a favorite maxim: ''There is more to the surface than meets the eye.''

The key to many psychological difficulties, Dr. Beck has found in 40 years of research and clinical work, lies not deep in the unconscious, but in ''thinking problems'' that are much closer to conscious awareness.

In the woman's case, for example, it turned out that she engaged in an endless self-deprecating monologue, an inner voice constantly berating her that she was unattractive, uninteresting and worthless.

And these ''automatic thoughts,'' as Dr. Beck calls them, led her to behave in self-defeating ways, like acting promiscuously because she did not think she had much else to offer, or engaging in histrionics in an effort to seem more interesting.

Cognitive therapy, developed by Dr. Beck after he abandoned psychoanalysis, is intended to help patients correct such distortions in thinking, often in a dozen sessions or fewer.

Dr. Beck calls the method ''simple and prosaic,'' with no dredging up of lost childhood memories, no minute examination of parental misdeeds, no search for hidden meanings.

''It has to do with common-sense problems that people have,'' he said.

Patients in cognitive therapy are encouraged to test their perceptions of themselves and others, as if they were scientists testing hypotheses. They receive homework assignments from their therapists. They learn to identify their ''inaccurate'' beliefs and to set goals for changing their behavior.

It is an appealing package. And in an age when managed care closely monitors the consulting room, and most psychiatrists view drugs -- not talking -- as the treatment of choice for their patients, Dr. Beck's approach has been able to provide hard data in support of psychotherapy's power.

Cognitive therapy's basic precepts are easily summarized in training manuals and its simplicity makes it an ideal research tool. And dozens of studies have shown it to be effective in treating depression, panic attacks, addictions, eating disorders and other psychiatric conditions. Researchers are also studying the therapy's ability to treat personality disorders and, in combination with drugs, psychotic illnesses like schizophrenia.

Therapists from around the world travel to the Beck Institute for training. And mental health organizations like the National Mental Health Association recommend cognitive therapy to patients as one of the few forms of psychotherapy studied in large-scale clinical trials.

Yet every theory of the human mind in general springs from a human mind in particular. Freud, caught in his own Oedipal struggles, saw the unconscious as roiling with sexual and aggressive impulses. Fritz Perls, possessed of a biting wit and fond of confrontation, invited his patients to take the ''hot seat.'' Carl Rogers, a former seminarian and by all accounts an empathic soul, argued that psychotherapy should be ''client-centered.''

And in its way, cognitive therapy -- practical, cerebral and to the point -- is also a fair reflection of the man who conceived it.

He is 78 now, an emeritus professor of psychiatry at the University of Pennsylvania, four times a father, eight times a grandfather.

Yet even as a younger man, his former students say, Dr. Beck, with his white hair and the bow tie he carefully put on each morning, projected a grandfatherly air, offering a nurturing presence, a passion for collecting data, a conviction that evidence always trumps opinion.

Others in his position might cultivate the flamboyance Americans seem to expect of their therapy gurus. But Dr. Beck has more in common with Marcus Welby than Dr. Laura Schlessinger or John Bradshaw -- his currency ideas, not personal charisma. Soft-spoken and unexcitable, he wears a hat, chats amiably with strangers in elevators and uses words like ''gosh'' and ''gal.''